Miliary tuberculosis with cerebral, liver, prostate and retroesophageal involvement

Abstract

Miliary tuberculosis results from the lymphohematogenous spread of Mycobacterium tuberculosis and it is a rare form of this disease. The most affected places are the lymph nodes, pleura, and osteoarticular system, but any organ can be involved. Currently the disease is still endemic in developing countries by its close association with poor living conditions and malnutrition. Other comorbidities, particularly infection by human immunodeficiency virus (HIV), diabetes mellitus, smoking and alcoholism are of great importance in the epidemiology of this disease. The authors describe the case of an adult man from Guinea-Bissau that has been residing in Portugal for the last few months, admitted with complaints of headache. He was submitted to a computerized tomography (CT) scan of the brain which showed multiple lesions. This led to further study and the diagnosis of a disseminated tuberculosis with cerebral, liver, prostate and retroesophageal involvement. He was started on anti-tuberculosis therapy, achieving good results.

Keywords: Tuberculosis; cerebral tuberculosis; liver tuberculosis; milliary tuberculosis; prostate tuberculosis; retroesophageal tuberculosis.

Fig. 1

CT scan of the brain showing two lesions with a ring shaped enhancement.

Fig. 2

Ultrasound showing an enlarged prostate with nodular lesions.